Abstract
The effects of long-term antiepileptic combined therapy with phenobarbitone (PB) and carbamazepine (CBZ) on the major endocrine functions were evaluated in a selected group of 15 young males with partial epilepsy. The plasma basal levels of triiodothyronine (T3), thyroxine (T4), free thyroxine (FT4), thyrotropin (TSH), cortisol (CO), dehydroepiandrosterone-sulfate (DHEA-S), adrenocorticotropin (ACTH), growth hormone (GH), prolactin (PRL) and testosterone (T) were determined. TSH and PRL were also assessed in response to i.v. injection of thyrotropin releasing hormone (TRH). The results were compared with those found in 37 age-matched male volunteers. The most remarkable changes affected pituitary-thyroid axis and pituitary-adrenal axis, while the hypothalamic-pituitary response was normal. No correlation between hormonal changes and duration of epilepsy and therapy or ADs plasma levels was found. There seems to be considerable individual variability of response to antiepileptic therapy, probably depending on peripheral changes in the hormonal metabolism.
Sommario
La terapia cronica con PB e CBZ nei pazienti epilettici può provocare alcune modificazioni della funzione endocrina soprattutto a carico dell'asse ipofisi-tiroide ed ipofisi-surrene. Sembra esistere una considerevole variabilità individuale in risposta alla terapia, probabilmente dovuta alle modificazioni periferiche del metabolismo ormonale.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Strandjord R.E., Aanderud S., Myking O.L., Johannessen S.I.:Influence of carbamazepine on serum thyroxine and triiodothyronine in patients with epilepsy. Acta Neurol Scand, 63: 111–121, 1981.
Liewendahl K., Helenius T., Majuri H., Ebeling P., Ahlfors U.G.:Effects of anticonvulsant and antidepressant drugs on iodothryonines in serum. Scand. J. Clin. Lab Invest, 40:767–774, 1980.
Yeo P.P.B., Bates D., Howe J.G., Ratcliffe W.A., Schardt C.W., Heath A., Evered D.C.:Anticonvulsants and thyroid functions. Br Med J, 1: 1581–1583, 1978.
Liewendahl K., Majuri H., Helenius T.:Thyroid function tests in patients on long-term treatment with various anticonvulsant drugs. Clin Endocrinol, 8: 185–191, 1978.
Schönberger W., Grimm W., Schönberger G., Sinterhauf K., Scheidt E., Ziegler R.:Der Einfluss von Primidon auf die Schilddrusenfunktion. Deutsche Medizinische Wochenscrift, 25: 915–917, 1979.
Bentsen K.D., Gram L., Veje A.:Serum thyroid hormones and blood folic acid during monotherapy with carbamazepine or valproate. A controlled study. Acta. Neurol Scand, 67:235–241, 1983.
Rodin E., Subramanian M.G., Gilroy J.:Investigation of sex hormones in male epileptic patients. Epilepsia, 25 (6):690–694, 1984.
Dana-Haeri J., Oxley J., Richens A.:Reduction of free testosterone by antiepileptic drugs. Br Med J, 284:85–86, 1982.
Toone B. K., Wheeler M., Fenwick P.B.C.:Sex hormone changes in male epileptics. Clin Endocrinol, 12:391–395, 1980.
Barragry J.M., Makin H.L.J., Trafford D.J.H., Scott D.F.:Effects of anticonvulsants on plasma testosterone and sex hormone binding globulin levels. J Neurol Neurosurg Psychiat, 41: 913–914, 1978.
Gallagher B.B., Murvin A., Flanigin H.F., King D.W., Luney D.:Pituitary and adrenal function in epileptic patients. Epilepsia, 25(6): 683–689, 1984.
Franceschi M., Perego L., Cavagnini F., Cattaneo A.G., Invitti C., Caviezel F., Strambi L., Smirne S.:Effects of long-term antiepileptic therapy on the hypothalamicpituitary axis in man. Epilepsia, 25(1):46–52, 1984.
Masala A., Meloni T., Alagna S., Rovasio P.P., Mele G., Franca V. Pituitary responsiveness to gonadotropin-releasing and thyrotropin-releasing hormones in children receiving phenobarbitone. Br Med J, 281:1175–1177, 1980.
Aminoff M.J., Simon R.P., Wiedemann E.:The hormonal responses to generalized tonic-clonic seizures. Brain, 107:569–578, 1984.
Abbott R.J., Browning M., Davidson D. Serum prolactin and cortisol concentration after grand mal seizures. J. Neurol Neurosurg Psychiat, 43: 163–167, 1980.
Herzog A.C., Russel V., Vaitukaitis J.L., Geschwind N.:Neuroendocrine dysfunction in temporal lobe epilepsy. Arch Neurol, 39:133–137, 1982.
Pritchard P.B., Wannamaker B.B., Sagel J., Nair R, Devillier C.:Endocrine fucntion following complex partial seizures. Ann Neurol, 14:27–32, 1983.
Rootwelt K., Ganes T., Johannessen S.I. Effect of carbamazepine, phenytoin and phenobarbitone on serum levels of thyroid hormones and thyrotropin in humans. Scand J. Clin. Lab. Invest., 38: 731–736, 1978.
Luoma P.V., Myllyla W., Hokkanen E.:Elevated serum growth hormone levels in patients treated with anticonvulsants. In Canger R., Angeleri F., Penry J.K., Advance in epileptology New York Raven Press, 1980:431–433.
Jeffcoats S.L.:Diagnosis of hyperprolactinaemia. Lancet, 2:1245, 1978.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rozza, L., Marcolla, A. & Ferrari, G. Endocrine function changes in young males during long-term antiepileptic therapy with phenobarbitone and carbamazepine. Ital J Neuro Sci 8, 331–336 (1987). https://doi.org/10.1007/BF02335735
Issue Date:
DOI: https://doi.org/10.1007/BF02335735